The Relationship Between IBS and Migraines

Sign Up for Our Digestive Health NewsletterThanks for signing up!Sign up for more FREE Everyday Health newsletters.SubmitWe respect your privacy.Carol Stevens has had symptoms of IBS for as long as she can remember. Then, when she was in her thirties, she started getting migraine headaches as well. “The pain would last for days and sometimes a couple of weeks,” said the now 60-year-old public relations professional in Westchester, N.Y.IBS is a common, chronic disorder with abdominal pain or discomfort, and diarrhea, constipation, or both. “Many IBS patients, especially women, also report symptoms unrelated to digestion such as fatigue, muscle pain, sleep disturbances, and sexual dysfunction,” said Bethany DeVito, MD, gastroenterologist at North Shore University Hospital in Manhasset, N.Y.Migraine headaches are vascular headaches that cause severe pain around the eye or temple area, face, sinuses, jaw, or neck. For many migraine sufferers, these headaches are debilitating.Though Stevens never saw her IBS and migraines as being related, there is an established connection between IBS and migraine headaches in the medical community, Dr. DeVito said.A 2005 study, for example, published in the Polish Journal of Neurology and Neurosurgery found that 23 to 53 percent of people with IBS experience frequent headaches, and that 10 to 20 percent of the population suffers from both migraine headaches and IBS.Another, published in BMC Gastroenterology the following year, reported that people with IBS were 40 to 80 percent more likely to also have migraines, fibromyalgia, and/or depression than people without IBS.More recently, a 2012 study published in Current Pain and Headache Reports found a further connection between migraine headaches, IBS, and celiac disease, the intolerance to gluten.IBS and Migraines: Timing Is EverythingFor some, symptoms of IBS and migraine headaches strike at the same time. “During the migraine attacks, some patients also have associated gastrointestinal disturbances, such as nausea, vomiting, abdominal pain, and diarrhea,” DeVito said.Other migraine sufferers report IBS symptoms between headache attacks as well, added Maxwell Chait, MD, gastroenterologist at Columbia Doctors Medical Group in Hartsdale, N.Y.Why the connection between migraine headaches and the digestion disturbances of IBS?There are a few possible reasons. Researchers in the Current Pain and Headache Reports study traced the link to a genetically sensitive nervous system that turns overly vigilant, which can, over time, lead to chronic pain diseases like IBS and migraine headache.Stress also factors into the connection between the head and the gut. “This mind-body connection is real and can greatly influence health,” Dr. Chait said.One specific player is the brain chemical serotonin. “Serotonin is a major neurotransmitter of the gastrointestinal tract that plays a relevant part in IBS as well as migraine,” Chait said.Strategies to Break the Mind-Gut Pain ConnectionYou can take steps to control both your migraines and IBS:De-stress. As stress and anxiety increase, so do episodes of IBS and migraine headaches, DeVito said. To help reduce stress, try to identify and defuse its sources, such as finances, work, or relationships. Avoid unhealthy coping mechanisms like smoking, drinking alcohol, using drugs, and overeating. Instead, eat healthfully, get enough sleep, exercise regularly, and drink plenty of water. Make time for things you enjoy, such as reading a book or magazine, listening to music, taking a leisurely walk, and other stress-reducing activities like aerobic exercise, meditation, and yoga. If you feel overwhelmed, talk to a mental health professional.Consider medication. Because serotonin plays a role in IBS and migraine headaches, medications that help maintain serotonin levels in the brain may help with both conditions. “For IBS, the drug tegaserod (Zelnorm), a serotonin receptor agonist, is used in people with constipation,” DeVito said. “And alosetron (Lotronex), a serotonin receptor antagonist, is prescribed for people with IBS-related diarrhea for which other medications have failed.”Serotonin agonists called triptans are the most commonly prescribed drugs for migraines and include sumatriptan (Imitrex) and almotriptan (Axert); they also help maintain levels of serotonin in the brain.Get educated. The better you understand your IBS and migraine headaches and what triggers them, the less anxiety you will experience surrounding your pain and other symptoms, and the better you will feel. If you have specific questions about your IBS or migraine headaches, ask your health care professional. Or research them at reputable sites online, including The National Headache Foundation or the National Institutes of Health’s National Digestive Diseases Information Clearinghouse.Watch your diet. With both migraine headaches and IBS, foods and beverages can trigger symptoms. “For IBS, dietary advice includes avoiding dairy products, fatty foods, caffeine, and gas-producing foods (such as beans and cruciferous vegetables),” DeVito said. For migraines, potential triggers include chocolate, red wine, coffee, aged cheeses, and the food additive MSG. Keeping detailed records of what you eat and how you feel afterward will help you pinpoint food triggers of your headache and IBS symptoms.When it comes to controlling migraine headaches and IBS, different treatments work for different people. As a first step in finding relief for all your IBS and migraine symptoms, talk to your health care professional.